Abstract Rationale Chronic lung disease is suggested to be a risk factor for stress urinary incontinence (SUI), an involuntary leakage of urine with activities that increase intra-abdominal pressure and load the pelvic floor, such as cough. The suggested risk is based on studies in obstructive lung disease, where SUI is associated with the high frequency of cough. The purpose of this study was to investigate stress UI in a pulmonary population where cough is not a primary symptom- lymphangioleiomyomatosis (LAM), a rare, progressive interstitial lung disease that affects mostly women of childbearing age. Methods This cross-sectional prevalence study surveyed 385 women (age 18-80 yrs) that included n = 167 women with LAM and n = 218 women without LAM (CON) matched for the major SUI risk factors of age, BMI, and parity. The survey was modeled after one previously published for COPD and cystic fibrosis (CF) and queried urinary and respiratory symptoms, lung function, fatigue, SUI reporting, and overall health status. Analysis was performed with Welch’s t-test (continuous data) and chi-square and Mann-Whitney U tests (ordinal data), and linear regression determined risk factors for SUI. Results The prevalence of SUI was higher (p 0.0001) in LAM (72%) compared to matched CON (48%), and similar to the incidence recently reported for COPD (59%) and CF (66%). Compared to LAM without SUI, LAM with SUI did not have more cough or lung impairment (p 0.05), but reported more dyspnea (p = 0.02), phlegm production (p = 0.01), and fatigue-related symptoms (p = 0.04). In risk regression, increased frequency of phlegm (p = 0.01), dyspnea (p = 0.01), and loss of urine during episodes of dyspnea (p = 0.03) emerged as significant predictors for SUI in LAM. Less than a third of LAM with SUI reported symptoms to their medical providers and, when they did, prescribed treatments were commonly inconsistent with current recommendations. Conclusion A higher prevalence and underreporting of SUI in women with LAM suggest need for targeted SUI screening and management to address a potentially overlooked complication of the disease with known impact on QoL. Future research should investigate mechanisms for greater SUI in LAM and other chronic lung disease, and how respiratory sequelae may impact function of the pelvic floor. This abstract is funded by: None
Brown et al. (2026) studied this question.